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A large proportion of people with diabetes do not receive adequate preventive care services, according to a study sponsored by the Centers for Disease Control and Prevention (CDC) and reported at the Diabetes Translation Conference held by the CDC April 30–May 3 in Atlanta.
"People at risk of complications from diabetes are not getting the attention they need," says Qaiser Mukhtar, PhD, a member of the CDC's Applied Behavioral Research, Epidemiology, Surveillance, and Evaluation Team.
A nationwide survey of 1,241 people with type 2 diabetes reveals a troublingly low rate of compliance with important preventive screening services. Among respondents, 67.9% reported receiving an annual foot examination, 63.3% an annual dilated eye exam, 60.9% a pneumococcal vaccine, and 60.1% an influenza vaccination.
Among those who had received a foot exam, only 50.3% reported a monofilament foot exam, an essential diagnostic tool to assess sensory deficiencies linked to peripheral neuropathy.
About 81.2% of respondents reported two or more tests for glycated hemoglobin (A1C) in the past year. Of those, 57% did not know their A1C value. More than 16% reported an A1C number <4% or >14%, such as 160 or 330, suggesting they were confusing the result with some other test, such as one for blood glucose level.
"It appears that people confuse A1C value with their blood glucose value," says Mukhtar. "There is a lot that needs to be done to educate people with diabetes about their A1C value, what it means, what their target value is, and what steps they need to take to achieve better glycemic control. Without these steps, an A1C test is meaningless."
The data were derived from the HealthStyles 2004 survey. An annual survey
conducted by social marketing and public relations firm Porter Novelli,
HealthStyles includes a national sampling of TV viewers 
18 years old.
Although the survey relies on the memories of participants and may not accurately reflect practices in the clinical setting, the findings highlight gaps in patients' knowledge of the need for regular preventive screenings.
"There is a need to educate providers about communicating to patients
with diabetes about preventive care services," says Mukhtar. 
Footnotes
For information about the Centers for Disease Control and Prevention's Diabetes and Flu/Pneumococcal Campaign to promote immunization, go to http://www.cdc.gov/diabetes/projects/cdc-flu.htm.
The National Institute of Diabetes and Digestive and Kidney Diseases' National Diabetes Information Clearinghouse offers patient education tools on subjects such as glucose monitoring, foot screening, and eye screening at www.diabetes.niddk.nih.gov/dm/pubs/complications/index.htm.
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| DOC News | Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |
